Improving Access to Integrative Oncology Through Group Medical Visits: A Pilot Implementation Project.
Improving Access to Integrative Oncology Through Group Medical Visits: A Pilot Implementation Project.
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通过团体就诊改善综合肿瘤学的可及性：试点实施项目。
DOI：
10.1089/acm.2019.0073
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Abrams,DonaldI
中科院分区：
文献类型：
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作者：
Thompson-Lastad,Ariana;Atreya,ChloeE;Chao,MariaT;Pollak,Christine;Dhruva,Anand;Santana,Trilce;Abrams,DonaldI
目的：本文介绍了实施一个小组医疗访问（GMV）模式，以增加获得综合肿瘤（IO）护理。获得高质量IO护理的最具挑战性和关键时刻是患者接受常规癌症治疗的时候。对个别IO诊所咨询的需求往往使这种情况无法发生。一个三届GMV计划的目的是减轻障碍，积极的癌症treatment.Design期间接受综合护理：一个统一的框架，用于实施研究和重点民族志方法来描述IO GMV实施过程。数据来源包括患者评估，参与者观察，简短的供应商和patient interviews.Setting：一个试点计划，以评估实施IO GMV在一个综合性cancer center.Intervention的可行性和可接受性：每个三届GMV包括一个教学会议，随后与integrated oncologist.Results的个人访问IO GMV程序的设置，干预和实施过程进行了描述。32名患者参加了该计划的前五个队列。其中22人为女性，24人为白色。参与者的平均年龄为52岁。患者评价表明对该计划的满意度很高，所有评分方面在五点Likert量表上评分>4.0。结论：GMV是一种可行的、有前景的增加IO访问的模式。积极接受癌症治疗的患者能够参加该计划。未来的研究和实施工作可以检查参与GMV后随时间推移的健康结果，以及将这种模型用于更多样化患者人群的可行性。
Objectives:This article describes the implementation of a group medical visit (GMV) model to increase access to integrative oncology (IO) care. The most challenging and critical time to access high-quality IO care is while patients are receiving conventional cancer therapy. Often demand for individual IO clinic consultations precludes this from occurring. A three-session GMV program was designed to alleviate barriers to receiving integrative care during active cancer treatment.Design:A consolidated framework was used for implementation research and focused ethnography methods to describe the IO GMV implementation process. Data sources included patient evaluations, participant observation, and brief provider and patient interviews.Setting:A pilot program was created to assess the feasibility and acceptability of implementing IO GMVs at a comprehensive cancer center.Intervention:Each three-session GMV consisted of a didactic session, followed by individual visits with the integrative oncologist.Results:The setting, intervention, and implementation process of the IO GMV program were described. Thirty-two patients participated in the first five cohorts of the program. Twenty-two were women; 24 were White. The median age of participants was 52. Patient evaluations demonstrate high levels of satisfaction with the program with all scored aspects rated >4.0 on a five-point Likert scale. For the medical center, group visits are a financially viable alternative to individual IO visits; revenue from group visits exceeded the revenue potential of 6 h of individual visits by an average of 38%.Conclusion:GMVs are a feasible and promising model for increasing access to IO. Patients in active cancer treatment were able to participate in the program. Future research and implementation efforts could examine health outcomes over time after participation in GMVs, as well as the feasibility of using this model with more diverse patient populations.